Best Practices for Working With ASL Interpreters

American Sign Language (ASL) is a primary language for communication for Deaf and hard-of-hearing individuals, and there are about one million people in the U.S. who use ASL as their primary means of communication. Therefore, it is important for care providers and clinicians to understand how to work with ASL interpreters to serve patients that belong to the Deaf or hard-of-hearing communities.

Below is a look at video remote and onsite ASL interpreting, when each modality is most fitting, and best practices for working seamlessly with both video and onsite ASL interpreters. 

Video vs. On-Site: Benefits of Each Modality and Best Usage Scenarios 

While onsite ASL has been the traditional way of serving Deaf patients, modern technology allows video remote ASL interpreting as well. Both forms of American Sign Language interpreting help providers meet the communication needs of Deaf or hard-of-hearing patients, and both offer unique benefits.

Video Remote ASL Interpreting 

Video Remote ASL interpreting is delivered via a camera or video device. The technology used to deliver remote interpreting has advanced and is highly reliable, effective, and efficient for care providers. This mode of interpretation works well for general in-office visits, telehealth appointments, and exams where general information is being exchanged.

On-Site ASL Interpreting 

On-site ASL interpreting is face-to-face, which gives all parties additional environmental cues that can help facilitate communication. This form of interpreting may be preferred when the Deaf patient uses a Sign Language other than ASL,  information being translated is especially emotionally charged or sensitive in nature, or if the patient is undergoing a procedure in which visual access to a video device would be compromised. In some cases, the in-person presence of the interpreter affords a bit of added emotional ease.

Best Practices for Video Remote ASL Interpreting

A few best practices apply in terms of getting set up for a video ASL interpreting session and while using this means of interpretation. Set up the video device so the patient has a clear view of the screen and the interpreter has a clear view of the patient's hands; the care provider doesn't necessarily have to see the ASL interpreter. The best setup usually involves both the screen/camera and the care provider facing the patient. Also, be considerate of Deaf patients that may also have visual impairments and adjust screen positioning accordingly or as needed.

A few other best practices include: 

• Eliminate background noise
• Make sure the room has enough light so the interpreter can see the patient's hands; use a spotlight if the lights must be lowered 
• Speak directly to the deaf patient, not the interpreter 
• Speak in first-person just as you are speaking to the patient, avoiding prefaced statements like "tell/ask the patient"
• Speak in a normal pace and tone; if the interpreter needs you to slow down or spell something out, they will ask
• Know the interpreter will translate everything you say, so avoid asking them not to or injecting personal or secondary conversations 
• If using documents or written materials, provide a copy to the Deaf patient and the interpreter

Certain best practices apply to every type of interpreting, including ASL. Unique to ASL interpreting is the tendency for interpretation to happen simultaneously, rather than consecutively. In most cases, you can expect the interpreter to begin signing while the provider is still speaking, and begin voicing while the Deaf patient is signing. In some cases where the language is highly technical for example, the ASL interpreter may choose to switch to consecutive interpreting, waiting to interpret until the provider finalizes their thought in order to render the most accurate interpretation possible. 

Best Practices for On-Site ASL interpreting 

The most important thing for on-site ASL interpreting is ensuring the interpreter has the ability to position themselves directly in the line of sight of the Deaf patient. The need of the Deaf person to see the ASL interpreter clearly should override everything else. This means that the exam may have to be carried out in a room that is configured in a way for the patient and interpreter to have enough space between them for a good view between the two individuals.

Other factors should also be considered when it comes to on-site ASL interpretation as well, such as: 

• The nature of the Patient’s visit — A patient in psychiatric crisis or under droplet precautions for example may require the interpreter to maintain more physical distance from the patient, yet a clear line of sight is still a priority. 
• The patient’s preference for interpreter gender, especially in sensitive healthcare conversations
• If the patient is alone — Positioning may differ if the interpreter will be communicating with a patient and family member, such as a parent and child

Build an Inclusive Care Model With ASL Interpretation